Breast cancer is commonly thought of as a woman’s disease; however, the American Cancer Society estimates that over 1,900 new cases of invasive breast cancer will be found in men in 2009.  Any man can develop breast cancer, but there are risk factors and some are similar to those for women.  (A risk factor is anything that makes a person susceptible to contracting a disease.)  Risk factors can be divided into those that can’t be controlled or changed, like family history, genetic makeup, and age, and those that can be, like obesity, excessive use of alcohol, and exposure to particular drugs or radiation.

One risk factor for male breast cancer is family history.  Anyone having a close relative (ie, mother or sister) with breast cancer has a slightly greater chance of getting the disease.  Nearly one of five men with breast cancer has a relative with it, too.

A second risk factor is genetic predisposition.  Defects in some genes, particularly BRCA1 or BRCA2, can put men at a higher risk of developing male breast cancer.  Generally these genes help prevent cancer by producing proteins that hinder abnormal cell growth; however, if these genes have a mutation they can no longer perform this function effectively.  A BRCA2 mutation means that a man has a 6% lifetime risk of breast cancer (ie, nearly 100 times more than the risk for other men).  Other mutations that denote an increased risk for male breast cancer are defects in the p53 tumor suppressor gene and the cell-cycle checkpoint kinase 2 gene.

The third risk factor is age.  The diagnosis of male breast cancer is most common in men between 60 and 70, with the average age range being 65 to 67.

Klinefelter’s syndrome is a congenital abnormality of the sex chromosomes X and Y.  A normal male has only one X and one Y chromosome.  Men with Klinefelter’s syndrome have two or more X chromosomes in addition to one Y chromosome.  This extra X chromosome causes abnormal development of the testicles, resulting in lower levels of male hormones (ie, androgens) and higher levels of female hormones (ie, estrogens), which can cause gynecomastia (ie, noncancerous breast growth).  Gynecomastia is not a tumor, but an increase in actual breast tissue.  It presents as a round, disk-like growth under the nipple and areola.  Even though this disorder is more common than male breast cancer, any lump under the skin should be checked by a physician.  It is possible that men with gynecomastia are at greater risk for developing male breast cancer, but this has not been confirmed.

Being overweight can increase one’s risk of breast cancer.  Obesity increases the number of fat cells in the body.  These fat cells convert androgens into estrogen, which then raises the amount of estrogen in the body.  Increased levels of estrogen increase the risk of male breast cancer.

Excessive alcohol use is a risk factor for male breast cancer, as are exposure to radiation and ingestion of estrogen.

A thickening or lump found in the breast is a common sign, and the lump is often painless.  Other symptoms of male breast cancer are puckering or dimpling of the skin, an inverted nipple, discharge of the nipple, and any changes in the skin of the nipple or breast, such as redness, itchiness or scaling.

Once cancer has been diagnosed and staged (ie, Stage 0, Stage I, Stage II A&B, Stage III A,B&C, and Stage IV), the patient must decide on treatment options.  Therapy is based on the stage of the cancer as well as the patient’s overall health, medical history and age.  Similar to treatment for female breast cancer, the main treatment option is a modified radical mastectomy.

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